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Wednesday, April 01, 2009

Purge chronicles Nicole Johns' memoir of her time in a eating disorders rehab center in Wisconsin for 88 days in 2004, when she was 23 years old, for EDNOS, a term meaning Eating Disorder Not Otherwise Specified. The writing is stark, interspersed with clinical documents like her intake documents, guidelines from the clinic, and the $24,500 bill for her treatment ($15,500 was covered by her insurance).

While anyone who's read any other first-person accounts of eating disorders, or lived with one, will find much that's familiar here--stuffing one's feelings with food, trauma, body dysmoprhia--there are several things different about Johns' story. She isn't a stick-thin anorexic, but rather a woman who's a size 9, who struggles with being at the upper end of the weight scale in the clinic. Yet by constantly purging (making herself vomit), she's wound up in the hospital and suffers from heart problems and had a concussion, along with other medical issues that will be with her for a long time, if not forever. She's also bisexual, though that isn't presented as a factor in her diagnosis; in fact, it's treated, refreshingly, as a nonissue, and seems to be a given to Johns.

When she writes things like, "My body has lost its integrity," it's something many, many women can relate to. Yet this is not a self-help book or one with a moral lesson per se. Johns is not holding herself up as an example, and in fact alludes to the danger of doing so when she writes that Marya Hornbacher's memoir Wasted is considered an "eating disorder bible" to many women suffering from eating disorders, and was banned from the treatment facility she attended.

Sometimes the point of view here is challenging, and I wished she had given us a little bit more of a glimpse of her current life, to see whether the back-and-forth nature of her attitude toward her eating disorder, which is omnipresent in the text presented, still holds. Yet Johns keeps her focus firmly on her time in treatment, with occasional hints of her growth in the years since. There are humorous moments, such as when one resident asks about the vibrator policy of the center (the therapist doesn't think they're allowed) and going skating with the elderly. There's repetition here that while probably deliberate, at times makes for tepid reading, but does mimic what surely was the repetitious days involved in her treatment.

Johns is at her best when telling the stories that are likely the most difficult for her; not the details of how and when and what she purged, but her feelings about and experiences with her family, and the possible date rape from her college advisor. These are told in a stark, direct way that serves to highlight these stories.

Purge is not an easy book, but an important one that will speak to those who've suffered eating disorders, known people who do or simply want to know more. The closing scene is a tearjerker, and highlights one of the biggest takeaways for me of Purge: the lasting, often life-threatening physical damage that can be done by bulimia. The medical reports that are included here certainly don't have the passion of her writing, but they can be just as chilling. Johns is open about how she didn't think she was doing that badly because she wasn't scrawny, and that is a reminder that one's outside appearance doesn't tell the entire story.